H.B. No. 412 aims to enhance health benefit plan coverage for early childhood intervention services in Texas. The bill amends the Insurance Code to include a broader range of rehabilitative and habilitative therapies, specifically adding dietary or nutritional evaluations, specialized skills training by certified early intervention specialists, applied behavior analysis treatment by licensed professionals, and case management services. It also clarifies that health benefit plans must provide coverage that complies with the new requirements and cannot impose annual or lifetime limits on these therapies, except for specialized skills training, which may have a cap of $9,000 annually.

Additionally, the bill stipulates that health benefit plans must honor individualized family service plans for children requiring these services and outlines that prior authorization requirements are satisfied if the service is included in the child's plan. The legislation will take effect on September 1, 2025, and will apply to health benefit plans delivered, issued for delivery, or renewed on or after January 1, 2026. Plans in effect prior to this date will continue to be governed by the existing law.

Statutes affected:
Introduced: Insurance Code 1367.201, Insurance Code 1367.202, Insurance Code 1367.204, Insurance Code 1367.205, Insurance Code 1367.206 (Insurance Code 1367)